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Care Transitions is a Centers for Medicare & Medicaid Services quality improvement project for Texas' Lower Rio Grande Valley administered through TMF Health Quality Institute. It is a regional, collaborative effort to reduce avoidable hospitalizations by improving patient care transitions. |
| Volume 1, Issue 4 |
February 2009 |
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| Provider Survey |
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Now Is the Time to Vote
The selection of the community-wide intervention plan is underway. A survey was e-mailed to each participating provider's primary contact person, and more responses are needed. Only 12 providers have responded, and at least 45 are needed.
This is a critical step in the Care Transitions process. Please review the discussion summary from the January meeting and then e-mail the Care Transitions team for a link to the online survey.
This should only take a few minutes to complete. Please help us move forward with the project by completing the survey.
Questions?
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| Newly Posted |
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 Visit the"What's New" section of the Care Transitions Web site to access newly posted resources and tools. |
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Care Transitions News is brought to you by
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In the News |
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U.S. to Compare Medical TreatmentsStimulus package funds include money for government to compare the effectiveness of different treatments for the same illness.
Speak Up Campaign Empowers Patients
This national campaign urges patients to take a role in preventing health care errors by becoming active, involved and informed participants on their health care team.
Decreasing Hospitalizations Through Reengineered DischargesIn this study, a discharge advocate (a trained nurse) met with patients prior to discharge and created a patient-centered discharge plan, which was given to the patient and primary physician. The intervention successfully reduced hospital utilization in the 30 days after discharge, primarily by reducing emergency department visits.
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Three-Fourths of Patients Can't Name Their Hospital DoctorsA new survey shows a majority of patients were unable to name a single physician assigned to their care. Of the 25 percent who named a physician, only 40 percent were correct. Would knowing a physician's name help a patient get better care?
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| HOME HEALTH |
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"E-Transition" Tools for Home Health Pilot TestedA centralized Web-based electronic system that streamlines real-time communication could alleviate the myriad of transition issues related to ensuring the right provider has the right information when it's most needed.
Updated HHPPS Fact Sheet ReleasedInformation about coverage of home health services and elements of the Home Health Prospective Payment System (HHPPS) is now available for download from the Medicare Learning Network. |
NURSING HOMES
Reducing Pressure Ulcers through "On-Time" QIThe Agency for Healthcare Research and Quality (AHRQ) has launched a program to help front-line nursing home staff reduce the occurrence of in-house pressure ulcers, providing residents with more efficient, effective and patient-centered care. The On-Time Quality Improvement (QI) for Long-Term Care program uses an innovative framework to improve day-to-day practice in nursing homes, improve and redesign workflow, enrich work culture and reduce pressure ulcers.
New Web Tool Helps Patients Choose a Nursing HomeCarolyn Clancy, M.D., director of the Agency for Healthcare Research and Quality (AHRQ), introduces Nursing Home Compare to consumers through a brief, easy-to-understand outline of the site's features.
Improving Outcomes for Residents with Lower Respiratory Tract InfectionsLower respiratory tract infection (LRI), which includes pneumonia, bronchitis and tracheobronchitis, is the leading cause of mortality and hospitalization in nursing home residents. Researchers have identified a prediction rule that may help clinicians who care for nursing home residents identify pneumonia without a chest x-ray. |
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PHYSICIANS and CLINICS
Considerations When Referring to Palliative Care at End of LifeWith more than 1,400 hospital-based palliative care teams and 4,700 hospice programs nationwide, physicians now have multiple options for referring to palliative care. This article discusses key considerations when referring to palliative care, including the difficulty in determining competence and quality.
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This material was prepared by TMF Health Quality Institute, the Medicare Quality Improvement Organization for Texas, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 9SOW-TX-CT-09-20
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